Ron Hines DVM PhD
Most mama dogs are wonderful mothers. But occasionally, when a mother dog is very young or one of the more temperamental toy breeds, she will neglect her offspring. Then there are the star-crossed and homeless dogs – the ones that can barely meet their own nutritional needs. They need a helping hand with their babies too. Occasionally, dogs just have too many puppies for them to nurse and care for adequately. In those situations, one or more puppies can fall behind in growth and vigor. In all those situations, you need to step in.
Some older mother dogs suffer milk failure and have no milk to give their puppies. Others produce contaminated milk ((toxic milk syndrome) or vaginal exudates that are toxic to the puppies. At other times, a litters contains one or two star-crossed runts that will not survive unless you assist and hand-raise them yourself. To survive, puppies born with substantial cleft palate must be hand fed as well. Any pup that weighs twenty or more percent less than its littermates is best raised by hand.
What Supplies Will I Need?
You will need to have a nest box for the puppy (s). Since the infants often soil their container, I usually find a small cardboard box that I can readily replace to keep the babies in. Pick up a few and replace them as need be. Just be sure nothing toxic or objectionable was stored in them.
I use a heating pad. I usually pick up a heavy-duty model at Walmart. Others feel safer with a hot water bottle. Then I go to their aquarium section and purchase an aquarium thermometer. The ones that contain a red liquid are more accurate than the strip type. A feed store chick thermometer works quite well too. In the same section you will find pet nursing bottles and, if you are lucky, Pet-Ag’s Esbilac™ brand of canned and dry puppy milk replacement. You can also purchase Esbilac powdered puppy milk online and at veterinary offices and pet stores. Just be sure the container hasn’t sat around a long time and that it does not smell rancid when you first open the can. It should not have lumps and clumps in it. If it does – return it. (I have no connection to Pet-Ag, its just that their products are usually the easiest to find. The Fox Valley Day One™ line is equally as good or better.
A small food scale is also very nice to have to weigh the infant(s). There should be a steady increase in their weight after their second day. If the pup is weak you may want to tube feed it. I will get to that later, but to do so, you will need several 3-ml syringes and I use 18 gauge butterfly infusion sets from a human hospital when I go that rout. Cut them to proper length and smooth the new tip with a lighter .
Delivering The Puppy
When puppies are born they are wrapped in a clear sac called the amniotic membrane or sac. This membrane must be removed from the puppy’s face in order for it to breathe. I tear this membrane away with my fingers and slide the whole puppy out. Then I use scissors to snip off the umbilical cord which connects the puppy’s belly button to the afterbirth. I leave about a half an inch of cord attached to the puppy and tie it off with a piece of silk thread so it will not bleed. Moms just chew it off, so there is really no need to tie them. Just something I learned in school. It is only a danger if the pup has any degree of umbilical hernia when it is born or inflammation at the base of the navel (omphylophlebitis). For that, see your veterinarian.
Then I use a rubber squeeze bulb to clean any mucus away from the puppy’s mouth, throat and nose. The same one they sell at the big box store for human infants.
The Nest Box Environment
Newborn puppies cannot generate enough heat to keep their bodies warm and have not yet developed a shivering reflex. They will rely on you to regulate their body temperature during their first 14 days of life. Normal rectal temperature for a newborn puppy is 94-98 F (34.4-36.7 C). By their second week of life, rectal temperature should be 97-100 F (36-37.8). By the fourth week their normal rectal temperature is 100-102 F (37.8-38.9 C)(the same as adult dogs). The first thing to do with chilled puppies is to warm them up, very slowly, to 95 degrees F (35 C).
Human-raised puppies need an environmental temperature of about 90°F (32.2°C) during their first week, in the mid 80’s the second week, and then in the mid 70’s. When the mother was there to keep the pups warm, additional temperature was unnecessary. When a pup reaches the end of its first month of life it will be happy at normal room air temperature of 70-75 F (21.1-23.9 C).
Be very cautious using the heating pad since the puppy can be easily hurt by too high a temperature while it is still too young to move away from the heat source. Overheating, inappropriate milk formulas and overfeeding with too large a volume (to make up for not feeding smaller amounts more frequently) are the greatest obstacles to success. Both overheated and under heated puppies will not absorb their milk formula normally from their intestines and are more subject to bloating.
The nest box does not need to be elaborate. For a newborn puppy, it needs to be just big enough for the pup to turn around but not much bigger. That helps conserves its body heat. Small puppies have difficulty maintaining their body temperature. These first few days, before the puppy can crawl, either keep room temperature around 86 F (30 C) or depend on a hot water bottle under the box. Once the pup can crawl to select its perfect temperature, a larger narrow box – about three times its length – with a heating pad on low setting under (not in) a third of it can be used. Wrap the heating pad with sufficient bath towels so that the inside of the box stays at about 90 F (32.2 C) but no higher. Puppies housed at that temperature will themselves be a few degrees warmer – more so if more than one are huddled together.
Be sure the box sides are tall enough so that the puppy cannot fall out. Line the nest box with clean bathroom hand towels, diapers. discarded underclothes, etc. Be sure that there are no threads or holes in the material for the puppy to get tangled in. Drafty areas are not good locations. As the baby matures the temperature in the box can be gradually lowered.
All young children delight in puppies. But young children are not good playmates for puppies. Keep puppies in areas away from children and other pets. You can buy the kids a new stuffed puppy to raise just like Mom (or Dad) is doing.
The First Milk Or Colostrum
Colostrum is the milk a mother dog produces the first days after birth. It is very thick, yellowish-cream in color, and rich in antibodies (especially IgA) and other factors (eg TGF-beta etc.) that protect puppies against disease. Read about canine colostrum here. Puppies that do not drink colostrum during their first 12 -14 hours of life cannot fight the diseases and bacteria they encounter as well as pups that do.
If your puppy could not nurse during its first day, giving it oral doses of blood serum or plasma from a healthy dog is one way veterinarians have tried to compensate for the lack of colostrum. (read here) After the first day (or perhaps 2 days – we are unsure), the puppy looses its ability to absorb most of the antibodies in colostrum. When colostrum was missing, you need to be especially sanitary when handling and feeding the puppy. Perhaps it might benefit from daily probiotics, yogurt, Bene-Bac® or other probiotic supplements. We really do not know when it comes to puppies, but these products appear to increase the health of colostrum-deprived pre-term human babies. (read here) It is better to give smaller amounts of these probiotic products over long periods than a whole lot at once. If the helpful bacteria within these gels or pastes are going to prosper in your puppy, it only takes a few organisms to seed its intestines. If its intestinal tract is not ready or hospitable to these bacteria, no amount will overcome that.
What To Feed The Puppy
I prefer to feed puppies a powdered Esbilac™ formula which I prepare from the powder before use. The chief reason I use the dry formula is that it is more economical – I feed a lot of infant animals. But you can use their canned product. It can be easier to find around town quickly and it doesn’t need to sit in your refrigerator for several hours to smoothly dissolve as reconstituted powder requires.
I store opened canisters of the powder on the top shelf of my refrigerator. When the canisters are nearing their expiration date, I only use them to supplement weanling animals. You can’t freeze the cans of liquid because it causes the ingredients to separate out. Allow some time after mixing a batch for bubbles to leave the formula. Really blend the powder well, so no lumps or goop remain. Ideally, I leave the reconstituted formula in my fridge for half a day until all grittiness has left. You can keep reconstituted formula in the refrigerator between uses, but discard any remaining formula at the end of the day. Pour just what you need into a secondary container and put the remainder back in the refrigerator immediately.
If, in an emergency or some remote location where you cannot obtain puppy milk replacement, you can mix an acceptable formula. Mine consists of one-half cup evaporated whole milk, one half cup boiled water, one teaspoon full of corn oil, one drop of pediatric human multivitamin (Visorbin® or equivalent), two raw eggs and a tablespoon full of plain whole yogurt. For some reason, formulas based on evaporated milk generally cause less diarrhea and indigestion than those based on fresh cow’s milk. Adding a quarter of a lactase tablet to each batch of formula might help the puppy deal with the large amount of lactose sugar present in cow’s milk. If it will be less than 24 hours before you can obtain a commercial puppy formula, you will be better off just giving healthy puppies pedialyte® until then.
A good puppy-nursing bottle holds 2-4 ounces of formula. They are generally sold without holes punched in the nipple. I use a flame-heated sewing needle to melt two small pin holes in the latex cap. The holes should only be big enough for a few drops of milk drip out when the bottle is held upside down. If too many holes are punched in the cap, the puppies tend to inhale the formula into their lungs rather than ingest it. If too few or too small a hole is made, the puppy will ingest too much air which can cause it to become bloated and colicky.
I feed the formula slightly above room temperature. Always feed pups the way mama dogs do – with the pup resting on its stomach in your hand or on a towel – not upright or upside down as you would a human infant. Gently insert the nipple into the pup’s mouth using a prying motion while you apply pressure to the sides of the bottle to release a drop or two of milk. From then on, the pup should suck on its own. There are good instructional videos on You-tube. Watch a few of them.
We all have a tendency to over-feed puppies. Its human nature to want to gratify infants with food. I have found that it is usually safer to give them a little less than they are willing to drink. Wait an hour, then give them a bit more. Over-feeding can lead to pneumonia when milk is inhaled into the lungs rather then swallowed into the stomach. It can also lead to diarrhea and bloat.
It is much safer to feed smaller amounts more frequently than larger amounts less frequently. If milk bubbles out of your puppy’s nose it is flowing too rapidly from the bottle. This is usually due to too large a hole(s) in the nipple or over-feeding. I microwave a bowl of water and set the bottle in it after it comes out of the microwave to heat the formula to be slightly warm to the touch.
Very rarely, a puppy will be born with a cleft palate. These puppies snort milk from their noses and must be tube-fed if you are planning to save them. You need to think hard before you decide. Birth defects often come in multiples and this pup may have other serious or life-ending defects. But if it is only the palate, your veterinarian can usually correct it when the pup is older.
Some owners find it easier to feed very small newborn pups from a one or three milliliter syringe and switch to a bottle when the pup is two weeks old. Since I get a lot of donated hospital supplies, I can usually find a short piece of gum rubber tubing to slip over the end like a nipple.
Boil pre-cleaned nursing bottles, syringes and utensils for 10 minutes between every use. Pop the syringe plungers out of the syringes so the steam penetrates all around. Syringes are good for many feeding – but eventually the plungers do not seal well.
How Much Milk Formula Should I Feed?
That is a very difficult question to answer because puppies arrive in so many sizes. Experienced breeders generally decide when a puppy has had enough, based on the shape of the puppy’s stomach and its greediness to continue feeding rather than by giving a set amount of formula.
But I can give you some idea: When the powdered formula I suggested is mixed according to directions (one part formula powder to two parts water); each day the average puppy needs 25-35 milliliters of formula for every 100 grams (about 3.5 ounces) of body weight. Divide this number by the number of feedings per day to obtain the amount for each feeding. During week two, give 15-20 ml for every 100 grams body weight. During weeks three and four give 20 ml for every 100 grams body weight. These amounts are always only a rough estimate. Feed the puppy until its belly is gently rounded or pear-shaped – never more. As long as it is slowly but steadily gaining weight and not bony, everything is going fine. I do not get up at night to feed when all is going well.
How Often Should I Feed The Puppy(s)?
Feed very young puppies every 2-3 hours or six to eight feeding a day. Some people get up to give their puppy a midnight feeding but this is not necessary if you have a vigorous ,healthy pup.
By the time the puppy is three weeks old, 4 feedings per day are quite sufficient. At 5 weeks of age, the puppy should be eating some solid foods. At this age feed it formula 2-3 times a day – if at all. Puppies that are hungry and need feeding will whine a lot, move their heads from side to side and suckle on each other and on objects in their nest box.
Burping The Puppy
After each feeding hold the puppy upright with its tummy against your wrist or arm and pat it gently until it burps – releasing trapped air. Nursing bottles that do not release enough milk can lead to more air being trapped and swallowed. You need to release that through burping. If the puppy should bloat or become colicky, a few drops of infant anti-colic medicine (eg simethicone, Equate Infants’ Gas Relief, etc.) added to the formula usually helps. If the problem persists, take the pup to your veterinarian.
Helping Your Puppy Eliminate
Normal puppy stools are yellowish brown with a jam-like consistency. After every feeding, gently massage the anus and urinary orifice with a cotton ball or Kleenex moistened with warm water until they urinate and defecate.
Be very gentle when you do this and don’t worry if no urine or stool is produced after every feeding. By the time the pup is three weeks old it should be able to do without your help.
Problems That Can Occur:
If diarrhea occurs, it usually helps to add more pedialyte to the formula to make up for the body fluid that they lost with the soft stool. You can even give feeding of pure pedialyte to allow the intestines time to recover. If this does not rapidly cure the problem, try a new rubber nipple and a different brand or container of milk replacement. If that does not quickly solve the problem or if the puppy becomes weak, take the pup to your veterinarian. Vets can give that extra fluid by injection. Puppies fade and dehydrate rapidly, so serious diarrhea must not continue for more than a day at the most. Blueness of the nose, jerky respiration and low body temperature are never a good sign.
When diarrhea is severe, your veterinarian may need to place the puppy on medications that slow the intestine and, perhaps,antibiotics. These puppies will almost always also receive injections of subcutaneous or intra-peritoneal fluids.
Puppies can also become dehydrated if their environment is too hot or dry. Two indicators of dehydration are loss of elasticity of the skin (the skin stays “tented” when it is gently pinched up) and decreased saliva production (the gums and tongue feel tacky or dry).
Hypoglycemia or low blood sugar can develop rapidly in a puppy that is not nursing. These puppies are limp, depressed, weak and they are cold to your touch. Their gums are often bluish and their muscles may twitch. Dextrose solution or corn syrup placed on their tongue is sometimes helpful – but their best chance at survival is in the intensive care setting of a 24-hour veterinary center where dextrose can be administered intravenously or intra-lingually (in the tongue). These vets can also provide high-oxygen, precisely controlled temperature environments.
Stools that are clumped and cheese-like can be due to feeding the formula too concentrated. When puppies strain to defecate and pass overly-hard stools, increase the frequency of feeding, reduce the amount and dilute the formula. Impacted pups also have bloated abdomens. You can give them a few drops of flavored mineral oil or cat hairball remedy to help them evacuate the stools. Never place amounts of unflavored laxative oils in a puppy’s mouth because they often inhale them rather than swallow them. If they still remain bound up, take them to your veterinarian. They may need a warm water enema or have an intestinal defect.
It is a good idea to worm your puppies with pyrantel pamoate when they are 4, 6, 10 and 12 weeks of age (Products that state on the label that they contain piperazine are not sufficient). Your having been hygienic is not sufficient to prevent intestinal worms in puppies – they could have passed into the puppy while it is still in the womb. (read here & here)
Fecal specimens from very young puppies with worms are often negative when they are checked microscopically. That does not mean the puppies do not have intestinal worms. That is because veterinarians are checking for parasite eggs in the stool – not adult parasites. The parasites (hookworms & roundworms) in puppies can take a number of weeks before they begin produce telltale eggs.
If the puppies are kept isolated from other dogs their first vaccinations can be given at 12 weeks of age. If other unvaccinated dogs are going to come in contact with the pup, the first vaccine should be administered at 6-8 weeks. The vaccine should immunize against canine distemper , canine canine hepatitis (adeno-2 virus), parvovirus and canine coronavirus. The most important vaccinations in this puppy’s life will be the ones it receives between 14 and 18 weeks of age. Be sure the vaccines used are a reputable ones (eg Zoetis, Boehringer Ingelheim/Merial, Merck) and not a cheap feed store product. Be sure it was stored and is administered correctly. I never include leptospirosis or Lyme in the vaccinations of a puppy – and I think twice about giving them to mature dogs as well. Read my dog and cat vaccine suggestions here.
At 12 weeks of age I give puppies their rabies vaccination and at 12, 14 and 18 weeks I give them the vaccines mentioned in the preceding paragraph. After the dog receives it first birthday vaccinations, it should need no more distemper-parvo-corona vaccinations for many years to come. In Texas, by law, dogs can receive a 3-year rabies shot every 36 months. Some special-case dogs might require periodic adult Lyme or leptospirosis vaccination but most don’t. How you handle rabies vaccination requirements is an administrative decision for normal house pets. I believe that dogs in the US receive entirely too many vaccination. Adult dogs need booster vaccinations for distemper/parvovirus perhaps every 7 years – probably never. Read more about what vaccinations your pet really needs.
I discourage tube feeding puppies that will nurse a bottle because puppies need the reassuring companionship they get when we slowly feed them from a bottle and talk to them. But puppies that are too weak to nurse do need to be tube fed. And people in rescue situation overworked with oodles of puppies need to keep their sanity.
It is difficult to explain the tube feeding process in writing. The best way to learn how to tube feed puppies is to have someone experienced in the technique do it together with you the first time.
When I tube feed, I fill a 3 or 6 milliliter (cc) syringe with warm formula, being careful that no air bubbles are present. Then I attach an eighteen-gauge infusion (butterfly) set to the syringe. The type in this photo with the scissors that I included earlier. I snip off the needle attach it to the disposable syringe and fill the remaining tubing and syringe with milk. Then I lay the tube along side the puppy and make a mark with an indelible pen on the tube when the tip is alongside the puppy’s last rib. Then I gently open the puppy’s mouth and begin to thread the tubing over the puppy’s tongue very slowly. This gives the pup time to swallow the tubing rather than have it go into its windpipe. If you are accidentally in the windpipe the pup will squirm and fuss.
When I think the tube is partially in place, with my thumb and index finger, I carefully palpate the puppy’s neck to feel two tube-like structures. the one in the center of the neck, will be the windpipe (trachea). The other will be the plastic tube. If I only feel one structure I remove the tube and reinsert it again until I am certain I am in the esophagus and not in the trachea. Then I slowly inject the contents of the syringe being sure the syringe is positioned not to inject air. When you are tube feeding, feed no more than 75% of what the puppy would have taken orally so it does not regurgitate the formula. Never grasp a just-fed puppy by its abdomen.
Bathing Little Puppies
During their first 2 week of life it is best to just clean puppies with a damp pledget of cotton. Younger puppies should get only partial baths. Do one section of them at a time with a soft, wet hand towel. When the “bath” is finished carefully blow dry the puppy. Be careful to keep the dryer far enough away from the puppy so as not to overheat it. I keep my hand in the air stream at puppy-distance to gauge temperature.
Check the puppy carefully for fleas as soon as you get it. If the pup has fleas, just pick them off one-by-one with tweezers, drop them into a bit of rubbing alcohol, then flush them down the commode. Throw away whatever box and bedding they came in or put the bedding through a hot air dryer cycle.
Weaning – You Are Almost To The Finish Line!
At between 3 and 4 weeks of age, puppies should begin accepting fine textured solid foods. By 4.5 to 5.5 weeks, the puppy should be weaned. Purchase some cans of gourmet cat or dog food in chicken and beef flavors and smear a bit on the roof of the puppy’s mouth to clue it in. Pups soon get the idea. I do not feed puppies very pungent foods because I fear it will make them into fussy eaters later in life. Early experiences mold food preferences.
This is the same time you should begin to offer formula to the puppy in a bowel. The earlier puppies eat on their own the better. I do not suggest human baby foods because many are too low in calcium. That can cause weak teeth and bones. Although many puppies will eat as early as four weeks of age, some take an additional two or three weeks before they have much interest in solid foods.
You are not going to succeed every time. Sometimes one pup, or a whole litter were just not destined to be. Occasionally, puppies are lost to herpes virus, but many more fade away from hidden genetic defects that occur at the metabolic level and that will never be identified. When a whole litter is born star crossed, it is better to never breed that mother again. Read about some of those unfortunate birth defects here.
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